Metabolize Information and Courses from MediaLab, Inc.

The urine specimen should be freshly voided. Urine is an ideal medium for the proliferation of bacteria due to the large amount of urea present. These bacteria metabolize urea, producing ammonia that increases the urine pH. If there is a delay before performance of the test, the sample should be refrigerated. This will: Prevent urease-producing organisms, such as Proteus and Pseudomonas, from converting urine urea to ammonia, which results in an increased pH. Prevent loss of CO2 which increases pH to the alkaline range.The "run-over" phenomenon may occur if excess urine remains on the strip. The protein area, adjacent to the pH area, contains an acid buffer which may "run-over" the pH portion resulting in an acid reading on a neutral or alkaline urine.

Ketone bodies are usually absent in urine. High levels of ketones are present in the urine of individuals with uncontrolled diabetes. In diabetes the ketones are present because the body's ability to metabolize carbohydrates is defective. Detecting the presence of ketones in the urine is a valuable aid to managing and monitoring individuals with diabetes mellitus. Ketonuria is an indication that the insulin dose needs to be increased. It is also an early indicator of insulin dosage problems in juvenile diabetes or in diabetics experiencing other medical problems. Electrolyte imbalance and dehydration occur when ketones accumulate in the blood. If these conditions are not corrected, the patient may develop acidosis and ultimately diabetic coma. Low levels may be detected during conditions of physiological stress such as fasting, rapid weight loss, frequent strenuous exercise or prolonged vomiting. The presence of ketones in these situations is due to either inadequate intake or increased loss of carbohydrates.

It has been said that we live in a new era of "individualized medicine". One of the primary drivers for this idea is the emerging field of pharmacogenomics (PGx). Pharmacogenomics (PGx) is the study of how individual variations in the human genome affect responses to medications. The term "pharmacogenetics" is also used for this discipline (people in the field use both terms); however, the term 'pharmacogenomics' is becoming more popular since we now know the entire human genome. The primary reason that individuals metabolize and respond to drugs differently is the inter-individual differences in receptor proteins and enzymes that metabolize the drugs. Mutations in these receptor proteins and enzymes can give rise to very different responses to drugs. In PGx, these mutations are referred to as variants.